CTS stats

Approximately 260,000 carpal tunnel release operations are performed each year and 47 percent of these are considered to be work-related.

A 1999 study reported that 14% of the population surveyed complained of symptoms such as pain, numbness, and tingling in the hands, but only one in five of these people actually had CTS.
source- arthritisinsight.com

This is why cts exercises are important

Carpal tunnel exercises should be performed at the start of each workday and after each break. These exercises decreases the amount of pressure on the median nerve in the carpal tunnel.
Workers with hand-intensive jobs should do a five-minute exercise warm-up before starting work, just as runners stretch before a run to prevent injury. In some older posts I have a lot of exercises that are to prevent carpal tunnel. I will post some more when I learn of new ones.

A single injection!

A single corticosteroid injection in the wrist can offer at least a month of relief to people suffering from severe carpal tunnel syndrome, according to an updated review of studies by Canadian researchers.Local injections are the most effective nonsurgical remedy for carpal tunnel, said Shawn Marshall, M.D., a specialist in physical medicine and rehabilitation at the University of Ottawa and lead author of the review. "One of the goals is to avoid surgery," he said.The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.Carpal tunnel syndrome is irritation of the nerve that passes from the wrist to the hand by way of the carpal tunnel. Repetitive stress commonly causes the syndrome, especially in industrial or manufacturing settings with vibrating tools. The most frequent symptoms are pain and numbness in the fingers. Severe carpal tunnel syndrome can cause permanent loss of feeling and partial paralysis in the thumb.This is the second update that Marshall and his co-authors have made since the initial publication of the review in 2000, which comprised three studies. Since then, there have been many more studies. For this update, the authors looked at a dozen studies with 671 participants.They found that a single local corticosteroid injection provided clinical improvement in symptoms at one month when compared to a single systemic injection. In two studies, patients showed significant improvement in less than one month after receiving a local corticosteroid injection when compared to receiving a placebo. Another study that compared receiving a local corticosteroid injection to taking an oral corticosteroid found greater improvement among those who received the injection as long as three months after treatment."There's building evidence to suggest that it works beyond one month," Marshall said.Injections to treat severe carpal tunnel syndrome are more common in Europe than in North America, Marshall said.Sometimes patients with very severe carpal tunnel syndrome receive corticosteroid injections although they also require future surgery. "It can work immediately," Marshall said.However, although they were more effective than oral medications, after two months, injections were no more effective than anti-inflammatory medicine, wrist splints or helium-neon laser therapy.For many years, physicians avoided local corticosteroid injections for fear of causing nerve damage, said Robert Werner, M.D., chief of physical medicine at the Ann Arbor Veterans Administration Medical Center in Michigan."I think [injections are] underutilized," said Werner, who was not involved with the study. Injections should be part of systematic approach to treating carpal tunnel syndrome, beginning with a wrist splint, he said, and if the splint does not provide relief, injections should become an option, followed finally by surgery, if necessary.Studies suggest that anti-inflammatory medicines provide little, if any, relief for the irritation symptoms, Werner said.The review did not look at the effectiveness of surgery compared to injections or the benefit of injections for treating less-than-severe carpal tunnel syndrome.Regardless of the medical or surgical treatment received, the overall treatment plan should include an ergonomic assessment of the workplace with the goal of reducing the risk of a repetitive stress injury, Marshall said. "It's a very complex picture, with many different angles."The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.
Visit http://www.cochrane.org for more information.
Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome (Review). Cochrane Database of Systematic Reviews 2007, Issue 2.Health Behavior News ServiceCenter for the Advancement of Health 2000 Florida Ave. NW, Ste 210Washington, DC 20009United Stateshttp://www.hbns.org

very interesting article

Heavy blogging and digging on an eight-year-old OSHA legend raises interesting questions about workers' compensation.
The story goes like this: Back in 1999 Marci Lyn Deutsch, a Florida phone sex operator, supposedly won a workers' compensation settlement alleging "she was injured after regularly masturbating at work." Her lawyer Steven Slootsky had claimed, according to reports, that she developed carpal tunnel syndrome in both hands because of repetitive self-gratification while speaking on the phone to customers as often as seven times a day. Deutsch had asked her employer CFP Enterprises for "$267 a week, based on her salary of $400, plus $30,000 to cover her medical bills after neurosurgery to relieve the pain in her hands." However, the case was settled for a "minimal" amount because "mediator Joseph Hand, a retired workers' comp judge, told her she'd have a tough time" winning.
While some consider this tale to be another example of America's "I sue, you sue, we all sue" culture, it seems unfair to say that just because someone derives pleasure from her job, it is frivolous to sue for an injury caused by that pleasure. After all isn't masturbatory carpal tunnel for a legal sex worker no different than typing carpal tunnel for a secretary? On the other hand, judges and juries might not be inclined to see it that way. After all, can you imagine a porn star attempting to get cash for a sex-related stress injury? Even in Australia, where prostitution is legal, "sex workers have entitlement to workers compensation for a work-related injury," but "[i]n practice this rarely occurs."
So as ridiculous as these cases may appear on the surface, they raise an important question that I'll throw out to you readers: Should the morality of one's job be called into question when interpreting employment law?
by Emil Steiner www.washingtonpost.com

Helping hands with CTS

COLUMBIA - Doctors say carpal tunnel results in more than two million visits to the doctor's offices each year.
In this week's Your Health with Angie Bailey, we take a look at a local doctor who's lending a helping hand.
A lot of those who have carpal tunnel don't know the early symptoms. The most common symptom is that your hands and fingers become numb and tingly while you're sleeping, causing you to wake up frequently during the night.
Dr. Matt Anderson has been an orthopedic surgeon at MU since June. He's an expert on relieving pressure for those with questions about carpal tunnel syndrome.
"I hope that people can come away with a basic understanding of the anatomy and causes of carpal tunnel syndrome and what kind of symptoms are related to that, so that they know when its appropriate to seek medical attention from a doctor," Anderson said.
Lisa Crowley helped coordinate the event and says information like this is important to the community.
"We like to go out to the community and present our orthopedic surgeons and give them an opportunity to see what type of services we do provide," said Crowley of MU Health Care.
Dr. Anderson hopes that having an open forum will help people better understand treatments.
"The simplest forms of treatment are activity modification, wearing a splint at night, sometimes trying an anti-inflammatory medicine, but as the severity of symptoms increases, we tend to need more things, such as injections, or sometimes surgery," Anderson said.
Dr. Anderson says surgery has advanced enough that now most people can return to work one to two days later.
Taken from www.ehand.com:
Symptoms usually start gradually with frequent burning, tingling, or itching. This is usually accompanied by numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent.
The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks.
In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to differentiate between hot and cold by touch.
Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. People with diabetes or other metabolic disorders that directly affect the body's nerves and make them more susceptible to compression are also at high risk.
Carpal tunnel syndrome usually occurs only in adults. The risk of developing carpal tunnel syndrome is not confined to people in a single industry or job. However, it is especially common in those performing assembly line work such as manufacturing, sewing, finishing, cleaning, and meat, poultry, or fish packing. In fact, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel. A 2001 study by the Mayo Clinic found heavy computer use (up to 7 hours a day) did not increase a person's risk of developing carpal tunnel syndrome.
During 1998, an estimated three of every 10,000 workers lost time from work because of carpal tunnel syndrome. Half of these workers missed more than 10 days of work. The average lifetime cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker.
Reported by:: Shayla Krile source- komu.com

Interesting news release!

"Carpal Tunnel Syndrome is now thought to be acquired mainly through genetics and biology rather than repetitive hand movement. Chiropractic care can help treat and prevent this ailment.
(AddPR) Carpal Tunnel Syndrome is the most common reported medical problem in the workplace, according to the U.S. Bureau of Labor and Statistics. It accounts for well over half of work related injuries and results in a median time away from work of 7 days, according to the Carpal Tunnel Syndrome Bureau of Labor Statistics Reports.How much does this ailment cost Americans in medical treatment and lost income? A staggering $27 billion per year, according to the American Academy of Orthopedic Surgeons!Dr. Mitchell Shea, a chiropractor in Cookeville, Tennessee and owner of Shea Chiropractic, aims at educating his patients about Carpal Tunnel Syndrome. He said, "Traditionally, Americans think the main cause of Carpal Tunnel to be repetitive hand use. New research indicates that biology and genetics actually play a larger role than ever expected."There are certain groups that are genetically more susceptible to developing Carpal Tunnel Syndrome. "It is almost like some people are preselected to be in a group of likely sufferers. Women, for example, are about 5 times more likely to suffer from it than men," said Dr. Shea. While opinions about the cause of Carpal Tunnel Syndrome have changed, treatment remains the same. Chiropractic is one of the primary choices for non-invasive treatment. Some treatments used at Shea Chiropractic include: manipulation, nutritional supplements, electro-acupuncture, the use of a splint, hand exercises, and therapies such as ice, ultrasound, and electrical stimulation. Dr. Mitchell Shea, D.C. has had great success in treating patients without the use of surgery. He urges patients to seek treatment while symptoms remain minimal, especially if there has been any history of it in the family.Often times, chiropractic offices, such as Shea Chiropractic will offer a discounted consultation or in some cases offer it free of charge. Contact your local D.C. if you have any questions about prevention and treatment of Carpal Tunnel Syndrome.
About Us: Shea Chiropractic is a family chiropractic center.
Contact Info: Dr. Mitchell SheaShea Chiropractic"

Surprising news!

Dr. Jeffrey Greenberg, an orthopedic hand surgeon at the Indiana Hand Center and a spokesman for the American Academy of Orthopaedic Surgeons, discusses carpal tunnel syndrome.
Question: What symptoms suggest you have carpal tunnel syndrome?
Answer: Carpal tunnel is a condition that causes numbness and tingling of the fingers of the hand. Classically, it involves the thumb, index finger, middle finger and the half of the ring finger that's closer to the thumb. It's caused by pressure on the median nerve, which runs in a relatively confined space at the wrist that also holds the nine tendons that bend your fingers.
One reason we think people get carpal tunnel is that the lining of the tendons becomes thicker, and that puts pressure on the nerve. There are many conditions that can cause that: age, diabetes, an underactive thyroid, pregnancy and inflammatory conditions like rheumatoid arthritis. The majority of people have idiopathic carpal tunnel in which we can't find an underlying cause.
Q: Is it more common today?
A: I think we're diagnosing it a lot more frequently, but I'm not sure that the frequency in the population is any greater.
There are some job activities that we do know can cause it, where vibration is generated and translated to the hand, like drillers, grinders, people who use power washers and weed eaters.
Q: How do you treat this?
A: The first thing we try to do is identify if a particular activity is causing the symptoms. With vibratory stimulation, we'll sometimes use a specially designed glove that has material in it to dampen vibration. We'll also use splints and injections of medicine, like steroids. The ultimate treatment, which is very effective, is surgery.
Q: Does technology play a role?
A: There's nothing scientific that shows that carpal tunnel is directly correlated to the usage we would typically associate with it, such as computer or keyboard. A recent study looked at computer programming and office work. We don't have any scientific evidence that shows those things cause carpal tunnel syndrome.
There is some evidence from epidemiological studies that shows other factors are more important, such as age, race and genetics. From an epidemiologic standpoint, these factors were twice as strong as repetitive hand use.
It's an interesting thing that we're learning. We have this entrenched in our society, if you work on a computer, you're going to get carpal tunnel, whereas there are other factors.

Contact Info

For more information on carpal tunnel syndrome, contact the:
-- National Women's Health Information Center, 800-994-9662;
-- National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse, 301-495-4484, 877-226-4267 or www.niams.nih.gov;
-- National Institute of Neurological Disorders and Stroke, 301-468-5981, 800-352-9424 or www.ninds.nih.gov;
-- National Institute for Occupational Safety and Health, 513-533-8471, 800-356-4674 or www.cdc.gov/niosh/pubs.html;
-- American Academy of Orthopaedic Surgeons, 847-823-7186, 800-346-2267 or www.aaos.org;
-- American Chronic Pain Association, 916-632-0922 or www.theacpa.org;
-- American Society for Surgery of the Hand, 404-523-8821 or www.hand-surg.org.

Treatment options

If you develop carpal tunnel, see a doctor to avoid permanent damage to the nerves and muscles of the hand and thumb. Trust me, this is a very important step. Treatment options include:
-- Physical therapy to strengthen the wrist and hand; yoga, ultrasound, chiropractic manipulation and acupuncture to reduce symptoms; massage to relieve pain, slow CTS progression and boost grip strength, according to a report by University of Miami School of Medicine researchers published in the Journal of Bodywork and Movement Therapies.
-- A wrist splint, worn round-the-clock or only at night within three months of symptoms to support and brace the wrist until the nerves and tendons recover.
-- An occasional rest from the repetitive motion to reduce or eliminate mild symptoms.
-- Temporary use of nonsteroidal anti-inflammatory drugs -- aspirin, ibuprofen and other non-prescription pain relievers -- to help control discomfort. In severe cases, it may take a cortisone injection or corticosteroids pill to reduce swelling. Diabetics should be aware long-term corticosteroid use can make controlling insulin levels more difficult.
CTS surgery, one of the most common procedures performed in the United States, is usually reserved for severe cases after other treatments have failed for at least six months.

Keep your hands warm

Government and other scientists recommend taking steps to prevent carpal tunnel syndrome, including:
-- Change your work environment to lessen the stress and strain on the wrist and hand. Make sure the workspace and equipment are at the right height and distance for the hands and wrist. For computer users, the keyboard should be placed high enough to permit the wrist to rest comfortably without bending. For most people, the workspace should be some 27 to 29 inches above the floor. Keep your elbows close to your sides as you type to reduce the strain on your forearm. Maintain good posture and wrist position.
-- Take a 10-to-15-minute break every hour to give your hands and wrists time to rest and recover.
-- Vary your tasks, avoiding repetitive motions, or at least breaking them up each hour with movements that work different muscles.
-- Relax your grip, unwind your muscles and practice gentle, loose hand and wrist motions to avoid stress and tension that can strain and irritate muscle.
-- Exercise, flexing and bending the wrists and hands in the opposite direction from the repetitive movement. A sample: after typing, make a tight fist, hold, stretch the fingers, hold, repeat several times.
-- Keep your hands warm, even if you have to wear fingerless gloves during work.

Bad news for us women

According to the Department of Health and Human Services, women are three times as likely as men to suffer from CTS, perhaps because their wrist bones tend to be smaller, creating a tighter space through which the nerves and tendons must pass. Their genetic makeup may also increase the likelihood of musculoskeletal injuries, and their hormonal changes during pregnancy and menopause may make them more susceptible. CTS also can be brought on or exacerbated by a misalignment of the carpal bones and wrist, trauma to the wrist, arthritis, gout, neck and shoulder problems and tumors.